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Music
Teacher National Association
New Member
Application |
(Individual membership year
begins July 1, 2005, and ends June 30, 2006)
(Student membership year begins October 1, 2005, and ends September 30,
2006)
Please note that the dues amounts listed are valid for the 2005-2006 membership year ONLY. If the current date is after July 2006, you can still use this form but you MUST check the MTNA web site for updated dues amounts for the current year!
How to Join MTNA
1) Print out and complete the
MTNA membership application form below.
OR
Click here to download
the PDF version.
2) Indicate your appropriate
state dues on your membership application form. Follow this link to the Active
Member State Dues or Collegiate Member State
Dues to find the appropriate dues amount. Add that
amount to the national dues fee. This is your total dues amount and will
cover membership through June 30, 2006. State membership is required.
MTNA membership year runs July 1 through June 30. If local
membership or MTNA collegiate membership is of interest to you, please call
MTNA at (888) 512-5278 for further information.
3) Please make check payable to
MTNA for the total dues amount and send with your membership application
to Music Teachers National Association, The Carew Tower, 441 Vine St.,
Ste. 505, Cincinnati, OH 45202-2811.
| Your name: |
______________________________________________ |
| Street/County: |
______________________________________________ |
| City/State/Zip code: |
______________________________________________ |
| Area code/Telephone: |
______________________________________________ |
| Fax number: |
______________________________________________ |
| E-mail address |
______________________________________________ |
| Birthdate: |
______________________________________________ |
| Sex: |
___ Female ___ Male |
| Teaching Field(s): |
______________________________________________ |
| Primary Teaching
Situations: |
___ Independent ___
College* ____ Other ___ Student* |
| * At which
institution? |
______________________________________________ |
| If student,
current year of study: |
___ Freshman
___ Sophomore ___Junior ___ Senior
___ Masters ___ Doctorate ___ Other: ___ |
| Highest Degree Attained: |
___ High
School ___ Associates ___ Bachelors
___ Masters ___ Doctorate ___ Performance Diploma |
| MTNA Membership Dues
(check one) |
| ___ Active Member |
| (join between
7/1-12/31/05) |
$56.00 |
| (join between
1/1-6/30/06) |
$28.00 |
___ Active
Member with Senior Discount
(70+ years of age) |
|
| (join between
7/1-12/31/05) |
$42.00 |
| (join between
1/1-6/30/06) |
$21.00 |
| ___
Collegiate Member |
$12.00 |
| ___
International Member (state
and local dues not applicable) |
$56.00 |
| ___ Patron
Member (state and local dues not applicable) |
$75.00 |
Please note that the dues amounts listed are valid for the 2005-2006 membership year ONLY. If the current date is after July 2006, you can still use this form but you MUST check the MTNA web site for updated dues amounts for the current year!
| |
|
| MTNA National Dues: |
|
| State Association Dues (must
be included): |
$ __________ |
| State
________________________________________ |
| Local or District Dues
(If
applicable): |
$ __________ |
| Local
________________________________________ |
| Student
Chapter Dues (If
applicable): |
$ __________ |
| Total Amount Enclosed |
$ __________ |
| Credit Card: |
|
| ___ MTNA
Mastercard ___ MasterCard ___ Visa |
___ American
Express |
| Expiration
Date: __________ |
|
| Card Number:
__________________________ |
|
| Signature
_____________________________________ |
Date: __________ |
Dues payable to MTNA may be
deductible as a business expense except for $30, which
constitutes the value of American Music Teacher magazine. Dues,
including $30 for the magazine, may also be deductible as a business
expense depending on your tax situation. You should
consult with your tax advisor. If you have any questions about state or local
dues, please call MTNA national headquarters at (513) 421-1420 or (888)
512-5278. Please
forward your completed form along with your payment to MTNA, 441 Vine
St., Ste. 505, Cincinnati, Ohio, 45202-2811.
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